Uso de un agente desensibilizante antes del clareamiento en consultorio: reporte de caso / Use of a desensitizing agent before dental bleaching: case report

La sensibilidad dental se presenta como un problema común e impredecible al realizar tratamientos clareadores, ya sea con técnicas caseras o de consultorio; generalmente esta sensibilidad es moderada y se produce durante o después del tratamiento, pudiendo llegar en algunos casos a interrumpir el tratamiento. Varios estudios sugieren la aplicación de productos desensibilizantes directamente en los dientes, otros adicionan estos productos a las pastas dentales y productos clareadores para reducir el malestar del paciente. En general, los dentistas tratan la sensibilidad cuando ya ocurrió, pero en este momento la cooperación del paciente puede estar ya afectada y como consecuencia llegar a un tratamiento insatisfactorio. El objetivo de este reporte de caso es demostrar un nuevo protocolo de clareamiento usando un agente desensibilizante antes del tratamiento para prevenir la sensibilidad. En este caso, fue colocado un agente desensibilizante en las caras vestibulares de todos los dientes anteriores por 10 minutos antes del tratamiento clareador en consultorio. El mismo procedimiento se repitió después de una semana. Se observó que el uso de un gel desensibilizante a base de nitrato de potasio y flúor antes del clareamiento en consultorio no afecta la eficacia clareadora del peróxido de hidrógeno y el paciente no indicó sensibilidad después del tratamiento.

Tooth sensitivity is a common and unpredictable problem when bleaching treatments are performed in-office and home techniques. This sensitivity is usually mild in nature and resolves either during or upon completion of treatment; however in some cases they are responsible for treatment with drawal. Several studies suggest the use of desensitizing products applied directly on the teeth, others added in the formulation of toothpastes and bleaching products to reduce the discomfort for the patient. In general, dentists treat sensitivity after its occurrence, but at this time the cooperation of the patient may already be affected, leading to an unsatisfactory outcome. The objective of this case report is to demonstrate a new technique of using desensitizing products to prevent the sensitivity. In this case, before the in-office bleaching technique, a desensitizing gel was applied on the buccal surfaces of the anterior teeth for 10 min. The same procedure was repeated after one week. It was observed that the use of the desensitizing gel (5% nitrate potassium/2% NaF) before the in-office bleaching does not affect the bleaching efficacy with hydrogen peroxide and the patient did not indicate sensitivity after treatment.

Clorhexidina como alternativa para maximizar la longevidad de restauraciones adhesivas / Case report of an alternative to maximize the longevity of dentin-resin bonds using chlorhexidine

La resistencia de la interfase de unión dentina-resina puede verse directamente afectada al mediano y largo plazo debido a alteraciones morfológicas que revelan la desnaturalización parcial o completa de los constituyentes de esta interfase. Algunos protocolos vienen siendo estudiados con el fin de preservar esta interfase a lo largo del tiempo. Este artículo presenta el reporte de un caso clínico donde fue utilizada clorehexidina, como parte del procedimiento adhesivo, con el objetivo aumentar la longevidad de una restauración con resina compuesta. La revisión de literatura descrita justifica la técnica utilizada y destaca los beneficios de su uso.

The bond strength of dentin-resin interface may be directly affected in medium and long term due to morphological changes that reveal partial or complete denaturation of its constituents. Some techniques and clinical protocols are being studied in order to preserve this interface over time. This article presents a case report where it was used chlorhexidine, as part of the adhesive technique, in order to increase the longevity of a restoration with composite. The literature review justifies the technique and highlights the benefits of their use.

Esthetic perception towards different combinations of facial contours and upper incisor shape

Aim: The aim of this study was to assess the esthetic perception of adults with primary, secondary and higher education and recent dental graduates towards different combinations of facial contours and upper central incisor shapes. Methods: Photographs of 6 individuals with square, tapered and ovoid facial contours (2 per type) were modified to have the 3 different types of tooth shapes (square, tapered and ovoid) in each facial contour (total of 18 photographs). The 195 participants rated each photograph using visual analogue scales. Comparison between groups was performed using the Chi-square t-test ('alfa'=0.05). Results: No statistically significant differences (p>0.05) were found in the esthetic perception towards the frontal facial outline and upper incisor shape by participants’ educational level. In addition, the shapes of teeth perceived as the most esthetically pleasing were not always similar to the form of frontal facial outline evaluated. Conclusions: No general agreement was found in the esthetic perception towards the frontalfacial outline and upper incisor shape by educational level. Dentists tend to prefer ovoid shape tooth for almost all frontal facial outline.